MEDICARE: DR. KAREN L WILLING PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PY01606	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19469017	OTHER		BCBSKC INDIVIDUAL #

General Provider Information

NPI Number	:	1710021464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN L WILLING PH.D.

Provider Business Mailing Address
First Line	:	7920 WARD PKWY
Second Line	:	SUITE 250
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-2017
Country	:	US
Telephone Number	:	816-326-8351
Fax Number	:	816-326-8356

Provider Business Practice Location Address
First Line	:	7920 WARD PKWY
Second Line	:	SUITE 250
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-2017
Country	:	US
Telephone Number	:	816-326-8351
Fax Number	:	816-326-8356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	07/30/2011

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